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i 27 <br /> '1 EMS1 MC <br /> EMS MANAGEMENT&CONSULTANTS <br /> North Carolina Medicaid Reform Fact Sheet <br /> Updated 08/11/2020 <br /> EMS I MC has prepared this fact sheet to assist NC EMS providers to navigate through the changes to the <br /> North Carolina Medicaid program now launching on July 1, 2021. <br /> The NC Association of EMS Administrators (NCAEMSA) and EMS I MC are working closely with the NC <br /> Department of Health and Human Resources (DHHS)to ensure that we have a seat at the table as these <br /> important decisions are made. There are many aspects of the NC Medicaid Reform that will impact EMS <br /> providers in NC. The purpose of this fact sheet is to explain the most recent updates to Medicaid <br /> Managed Care. <br /> Medicaid Managed Care <br /> On February 4, 2019, NC Medicaid announced the contract awards to the managed care plans that will <br /> administer the Medicaid program. Using a competitive procurement process, NC Medicaid has awarded <br /> four statewide Prepaid Health Plans (PHP) and one regional, provider-led entity,to the following <br /> agencies: <br /> • AmeriHealth Caritas North Carolina, Inc. • WellCare of North Carolina, Inc. <br /> • BCBS of North Carolina • Carolina Complete Health (Regions 3 and 5) <br /> • UnitedHealthcare of North Carolina, Inc. <br /> Timeline <br /> MANAGED CARE & <br /> OPEN AUTO TRIBAL OPTION <br /> ENROLLMENT ENROLLMENT LAUNCH <br /> 3115121 5114121 7/1121 <br /> OPEN ENROLLMENT TRANSITION OF CARE <br /> NC EMS Providers will be expected to contract with the PHPs in order to receive payment for services <br /> provided to these Medicaid recipients. Claims will be filed to the PHP for eligible Medicaid recipients <br /> rather than directly to NC Medicaid. Infocrossing, LLC has been named the Provider Data Contractor, <br /> whose responsibilities will include credentialing of Medicaid-enrolled providers and sharing the <br /> information with the PHPs. The goal of the Provider Data Contractor will ensure a consistent process of <br /> enrollment. Under the managed care program,the Department will mandate that the PHP maintain a <br /> certain level of payment by establishing a rate floor, or minimum payment of 100%of the Medicaid fee- <br /> for-service rates. <br /> EMS MC I I <br />